Clinical hypnotherapy is used to treat a wide variety of psychological problems. The process of clinical hypnotherapy involves helping a patient achieve a very relaxed state and heightened state of suggestibility so that he/she will accept on a subconscious level ideas, beliefs or suggestions he/she might not otherwise be receptive to. The patient's lack of receptivity may be due to stress, tension or certain preconceived ideas. However, the purpose of these suggestions is to disrupt the patient's logic/thought pattern which has created the specific psychological problem.
For example, hypnotherapy may be used to treat people who suffer from extreme test anxiety. Typically, test anxiety results in the patient not fully performing up to his/her capabilities in test taking situations. A typical logic/thought pattern for such a person may be as follows: "If I do badly on the test then I will get a bad grade in the course-then I won't get into college-then I won't become a doctor-then I will be a total failure in life." In the patient's mind, the perceived consequences of performing poorly on the test are tremendous. The resulting anxiety from this logic/thought pattern may actually result in the patient performing substantially below his/her capabilities.
Hypnotherapy involves three separate phases, these being (i) a relaxation phase, (ii) a suggestion phase, and (iii) a post-hypnotic suggestion phase. The process begins with the relaxation phase whereby the therapist helps the patient become more comfortable and relaxed in order for the patient to be receptive to the therapist's suggestions. Once the patient has reached a sufficient level of relaxation, the therapist provides suggestions which are specifically intended to reduce the patient's symptoms. It is the purpose of the hypnotherapy to integrate these suggestions into the patient's subconscious mind so that the suggestions become urges to take a specified action or actions. The therapist will then include one or more suggestions intended to occur after the patient is removed from his/her state of deep relaxation or hypnosis. This set of suggestions are known as "post-hypnotic" suggestions. While they are provided to the patient in the hypnotic state, they are intended to be "cued" by stimuli which will occur later when the patient is no longer in the hypnotic state. That is, the patient is instructed (while in the hypnotic state) to experience the full strength of the post-hypnotic suggestion each time he/she later experiences a specific cue, such as a feeling of anxiety in anticipation of an upcoming test.
For example, the therapist might suggest to the patient (while the patient is in the hypnotic state) that any time he/she experiences anxiety about an upcoming test, to remember and experience the same feelings of relaxation as he/she is feeling while under hypnosis. In this case the post-hypnotic suggestion is "relaxation" which is to be triggered by an internal feeling (cue) of anxiety about an upcoming test (stimulus). Thus, the post-hypnotic suggestions recall the feelings of deep relaxation experienced during hypnosis and the patient "re-experiences" these relaxed feelings thereby disrupting his/her anxiety about the upcoming test situation.
Typically, hypnotherapy sessions are conducted by an experienced therapist who is actually present with the patient. In a formal hypnotherapy session for alleviating such problems as smoking, the therapist will develop a post-hypnotic suggestion which may be unique for the patient. For example, the post-hypnotic suggestion might be that when the patient pulls a cigarette from a cigarette pack, the cigarette will begin to get hotter and hotter between his fingers until he is forced to drop it to keep from being burned. Other suggestions might work better for other patients. For example, the therapist might suggest that the cigarette turns into a wiggling, slimy worm when it is pulled from the cigarette pack. The pack itself could be targeted for a post-hypnotic suggestion. For example it might be suggested that when purchasing cigarettes (the cue), the patient will begin to feel nauseous and dizzy (the post-hypnotic suggestion) and should go out into the street for fresh air.
Suggestions such as these are also used as aids in treatments other than hypnotherapy through the use of vivid images to achieve a desired outcome. For example, non-hypnotic imaging is used in conjunction with radiation and chemotherapy by oncology personnel. The patient usually is told to imagine himself (or a powerful surrogate) "sailing" through the bloodstream, finding and battling the cancer, and finally overcoming it. A patient might imagine herself finding the cancer as a huge knot of gnarled roots blocking her way. She would image that she obtained a small axe and laboriously severed each root, working persistently until the cancer could take no more nourishment from her. As she would cut the roots, they would wither, and finally, the cancer itself would die when all its roots were destroyed.
The current use of formal post-hypnotic suggestion or non-hypnotic heightened suggestibility (including imaging) has been used by mental health or medical professionals who directly (or indirectly through the use of audio-tapes) aid the patient by creating the state of heightened suggestibility and then place the post-hypnotic suggestion. Although suggestion and imaging might be used even in non-therapeutic environments such as sales motivation sessions, the state of heightened suggestibility and the suggestion placement are often controlled by a human session leader or might be delivered through a pre-recorded audio-cassette program.
In the foregoing conventional methods of placing and maintaining post-hypnotic suggestions, the therapist helps create the relaxed state of heightened awareness, places the post-hypnotic suggestion, and then terminates the hypnosis. Afterward, a (hopefully) recognized cue elicits the post-hypnotic suggestion from the patient's subconscious and the suggested behavior results, e.g. relaxation.
A significant problem with these conventional hypnotherapy processes is that post-hypnotic suggestions work well with some types of cues but not with others. Typically, the term "cue" means anything which is intended to elicit a post-hypnotic suggestion. For example, in the case of the post-hypnotic suggestion that a cigarette will start to get hotter and hotter when it is pulled from the cigarette pack and start to burn the smoker's fingers unless it is dropped, the cue might be when the patient reaches for his pack and feels a cigarette placed between his fingers. However, this type of cue is defined herein as an "external passive cue". That is, this cue, although located in the patient's external environment, relies upon the patient's ability to make the suggested connection between an the action of taking a cigarette from an ordinary pack of cigarettes and the heating up of the cigarette so that it burns the patient's fingers. There is nothing different or unusual about the pack of cigarettes to aid the smoker's subconscious mind in making the connection between the cigarette pack and the burning fingers. Furthermore, this particular cue is "object specific". That is, it depends upon the patient obtaining his/her next cigarette from a pack of cigarettes. For example, during a weak moment the patient could consciously bypass this cue (to avoid the unwanted consequences of "burning" fingers) by having his/her spouse or friend pull the cigarette from the pack and place it between his lips.
Another problem with the foregoing conventional hypnotherapy processes is that many of them depend upon the patient awareness of his/her "internal cues". For example, a post-hypnotic suggestion to relax when a patient is feeling anxious about an upcoming test requires the patient to cue on a particular internal state. However, the patient may not be able to recognize his/her internal state at the time. That is, internal cues are not as vivid or well defined as even external passive cues, and may be particularly inaccessible to patients that exhibit certain types of behavioral disorders. In fact, many individuals are normally insensitive to a whole host of internal states such as their internal level of anxiety.
Furthermore, these conventional hypnotherapy processes put the entire responsibility for maintaining the forward progress of the treatment with the patient, who is often the weakest link. This is a particular problem when the patient experiences anxiety or is distracted during the unwanted behavior. It is known that when the patient is in a state of anxiety, he/she is even less likely to initiate the proper steps to trigger the post-hypnotic suggestion.
Also, in terms of overall treatment effectiveness, the patient must remember to re-initiate the original hypnotherapy process each time he/she wants reinforcement of the suggestion. Thus, it is easy for a patient to drift away from the treatment regimen, especially with particularly intractable disorders such as cigarette smoking, alcohol abuse and overeating. It is also known that the post-hypnotic suggestion will degrade over time. That is, the overall strength of the post-hypnotic suggestion's ability to reduce the targeted symptoms will diminish in proportion to the length of time between the placement of the post-hypnotic suggestion and the occurrence of the cue.